SB 803 (Beall): Mental health services: Peer Support Specialist Certification – SUPPORT

February 19, 2020
The Honorable Jim Beall
California State Senator
California State Capitol, Room 2082
Sacramento, CA 95814

RE: SB 803 (Beall): Mental health services: peer support specialist certification – SUPPORT

Dear Senator Beall: The California Association of Mental Health Peer Run Organizations (CAMHPRO) supports Senate Bill 806, which would establish a statewide certification program for peer support specialists and would provide the structure needed to maximize the federal match for peer services under Medi-Cal. CAMHPRO is proud to be a co-sponsor of SB 803.

CAMHPRO promotes the work and missions of peer-run organizations devoted to advocacy and empowerment for mental health consumers. CAMHPRO’s mission is to transform communities and the behavioral health care system throughout California to empower, support, and ensure the rights of consumers; eliminate stigma, and advance self-determination for all those affected by mental health issues.

In supporting a Peer Support Specialist Certification Program in California, CAMHPRO joins the formidable array of California organizations, counties and individuals advocating for growth in high quality peer/family support services and peer specialist career development. Through support of SB 803, we look to finally bring peer support specialist certification to California.

Programmatically, peer certification makes sense
Numerous research studies support the efficacy and cost effectiveness of peer specialist services. Peer services, as opposed to traditional services alone, lead to less inpatient services, decreased symptoms, increased coping skills and life satisfaction, reduced overall ongoing need for mental health services, and decreased substance use.

Across California, peers are already providing peer support services. However, there is no statewide scope of practice, standardized curriculum, training standards, supervision standards, or certification protocol. Few counties that provide peer support services require training prior to hire. The benefits of Peer Certification for peer support are obvious.

Peer certification:
  • Defines the service of peer support;
  • Provides a standardized scope of practice, values and ethics, and competencies;
  • Assures that practitioners receive standardized training and demonstrate competency;
  • Ensures that service recipients will receive the same quality of services regardless of where in California they live;
  • Provides a basis for the ability to bill Medi-Cal for services provided; and
  • Allows for portability of Certification between counties.
Peer Certification also makes good fiscal sense, and California is one of only two states in the nation without it.

In 2007, the US Centers for Medicare and Medicaid Services (CMS) sent a guidance letter to all State Medicaid Directors emphasizing, “peer support services are an evidence-based mental health model of care which consists of a qualified peer support provider who assists individuals with their recovery from mental illness and substance use disorders.” CMS encouraged states to establish a state certification process for training, credentialing, supervision and care coordination. (CMS, SMDL #07-011). This enables the use of federal Medicaid (Medi-Cal in California) financial participation with a 50% match. Currently, 48 states, plus the District of Columbia and the US Department of Veteran’s Affairs, have implemented protocols to certify peer specialists, enabling them to leverage Medicaid funds. However, California has not acted and Californians deserve better!

Initially funded by Department of Mental Health and then Office of Statewide Health Planning and Development (OSHPD), California began an in-depth and focused look at peer certification in 2011.Substantial grassroots work has been done toward peer certification since 2012 and substantial government funds have already been invested into developing peer certification in California.

SB 803 makes sense from both a policy and fiscal perspective and will provide more comprehensive assistance to people in need. CAMHPRO is proud to be part of a statewide movement to bring California up to speed with the rest of the nation in recovery and resiliency services through a state protocol for Medi-CAL billing and certification of peer support specialists.

Sincerely,
Sally Zinman
Executive Director
CAMHPRO
sallyzinman@gmail.com

United States Department of Health & Human Services, Centers for Medicare & Medicaid Services, Guidance Letter to State Medicaid Directors, SMDL #07-011, August 15, 2007.

Click to access SMD081507A.pdf

Peer Certification is Back! SB 10!

Senator Beall has reintroduced SB 10, mental health  services: peer, parent, transition age, and family support specialist certification

See News Release from Senator Beall’s office:

Legislators Call for Urgent Action to Improve Mental Health Services and Delivery
December 03, 2018

SACRAMENTO — On the opening day of a new legislative session, lawmakers from the Senate and Assembly gathered to call for action to stem California’s mental health crisis.

“It’s no secret that access to integrated mental health services and provider shortages plague our state, resulting in deteriorated mental health outcomes for all Californians,’’ said Beall, chairman of both the Senate Mental Health Caucus and the Select Committee on Mental Health. “The lack of integrated, accessible mental health services is one of the greatest humanitarian challenges we face and we must invest in mental health infrastructure to save many, many lives.

“Early access to treatment is key. Three-quarters of all mental health issues have their onset by the age of 24. Yet adolescents and young adults are the group least likely to receive mental health care. State Auditor Elaine Howle identified that counties have millions of dollars in unspent mental health funds and the state is projecting now a massive budget surplus. With resources available and the need for comprehensive mental health so great, the time for legislation and legislators to act is now.’’

“Joining Beall were John Moorlach (R-Costa Mesa), and Assemblymembers Dr. Joaquin Arambula (D-Fresno), Kansen Chu (D-San Jose) and representatives from the Steinberg Institute, Mental Health America of California and the National Alliance on Mental Illness.

This morning, Beall introduced three bills to increase and ensure mental health services and treatment:

SB 10 increases the effectiveness of mental health and addiction supportive services by establishing a state certification process for peer providers — people with lived experiences as family members, clients, or caretakers of individuals recovering from addiction or mental illness – who guide and help their clients.

SB 11 strengthens enforcement of state and federal mental health parity laws by requiring health care service plans and health insurers to submit annual reports to the state to determine if they are complying with parity laws. The information would be available to the public on the website of either the Department Of Managed Health Care or the Department of Insurance.

SB 12 declares the intent of the Legislature to amend the existing Mental Health Services Act (Proposition 63) to authorize the state and local governments to establish at least 100 drop-in centers to meet youths’ needs. They would be modeled after the headspace project, an Australian national network comprised of “one-shop stop’’ centers for youth to ensure they have the coping skills and a support system in place for a successful transition to adulthood. In California, 17 percent of high school students reported they have seriously considered attempting suicide; 9 percent reported they have attempted suicide one or more times.

The need for mental health treatment, therapy, and counseling is high in California. Only three out of four Californians who have mental health needs receive treatment.

The legislators made clear that California must eliminate gaps in the delivery of mental health services.

Sen. Moorlach called for connecting mental health services to young people. “I think with the Mental Health Services Act and all the funding that’s available, redirecting, giving more focus, and getting things moving is so critical. We can’t have $2.5 billion sitting in bank accounts languishing when we have so many families in need,’’ he said.

Arambula said, “Our foster kids who are exposed to more trauma than most should not have to deal with the crisis of the moment by being penalized and being sent to a judicial system that is not ready to process them. Instead, we should be meeting them where they are at by providing wrap-around services, a social worker and a crisis line.’’

Chu said he supports having at least one mental health professional on school campuses. “I believe the most central location to provide wrap-around services is at the school,’’ he said.